Individual ProviderJonathan Taylor-FishwickStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address12631 East 17th Ave, Mailstop C316, Aurora, CO 80045(303) 724-6595PECOS EnrollmentBased on the most recent information from CMS, provider Jonathan Taylor-Fishwick is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 8:47 AM.Profile DetailsProvider ID1639756521Provider TypeIndividualFull NameTaylor-Fishwick, JonathanGenderMaleSole ProprietorNoEnumeration Date3/26/2021Last Updated3/26/2021Contact InformationPractice LocationPractice Address12631 East 17th Ave, Mailstop C316, Aurora, CO 80045Phone(303) 724-6595FaxUnlisted FaxMailing LocationMailing Address12631 East 17th Ave, Mailstop C316, Aurora, CO 80045PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer